Individual
HEMINA BHARATRAI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1601
(815) 490-1625
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1601
(815) 490-1625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9516
KY
Other
Enumeration date
07/09/2014
Last updated
07/02/2015
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